Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.05 / $1,473.03 / $17,100.00	Facility		$271.05	$1,473.03	$17,100.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $99.61 / $220.22 / $736.52	Facility	52	$99.61	$220.22	$736.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.66 / $448.68 / $1,318.81	Professional		$138.66	$448.68	$1,318.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $189.43 / $280.35	Professional		$131.16	$189.43	$280.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $574.02 / $4,266.04 / $8,681.78	Facility		$574.02	$4,266.04	$8,681.78
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,233.22 / $6,807.86 / $13,170.53	Facility	50	$4,233.22	$6,807.86	$13,170.53
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $302.42 / $530.45 / $530.45	Facility	52	$302.42	$530.45	$530.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $264.95 / $1,219.61 / $4,841.12	Professional		$264.95	$1,219.61	$4,841.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $899.11 / $899.11 / $1,497.91	Facility		$899.11	$899.11	$1,497.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.26 / $478.93 / $2,009.03	Professional		$236.26	$478.93	$2,009.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $238.71 / $841.80 / $2,361.46	Facility		$238.71	$841.80	$2,361.46
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,505.22 / $3,447.33 / $6,259.79	Facility	50	$1,505.22	$3,447.33	$6,259.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.23 / $734.00 / $2,151.16	Professional		$234.23	$734.00	$2,151.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $164.10 / $1,050.35 / $1,728.22	Professional		$164.10	$1,050.35	$1,728.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $296.81 / $1,080.71 / $1,327.94	Facility		$296.81	$1,080.71	$1,327.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $574.02 / $895.72 / $928.65	Facility		$574.02	$895.72	$928.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.14 / $485.90 / $1,728.70	Professional		$251.14	$485.90	$1,728.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,943.06 / $4,535.97 / $8,681.78	Facility		$2,943.06	$4,535.97	$8,681.78
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,414.59 / $6,803.97 / $13,022.67	Facility	50	$4,414.59	$6,803.97	$13,022.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $255.11 / $613.62 / $1,521.94	Professional		$255.11	$613.62	$1,521.94
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $1,396.45 / $1,937.77	Professional		$737.10	$1,396.45	$1,937.77